Parkinson's Disease: Assessment, Diagnosis, and Management

Leslie F. Nolden, DNP, FNP-BC; Todd Tartavoulle, DNS, CNS-BC; Demetrius J. Porche, DNS, PhD


Journal for Nurse Practitioners. 2014;10(7):500-506. 

In This Article


The etiology of PD remains unknown in most patients. PD is considered a nonhereditary disorder with etiologic associations to environmental factors.[3] The associated environmental risk factors include exposure to well water, pesticides, herbicides, industrial chemicals, wood pulp mills, farming, and rural residence. The association between PD etiology and environmental factors is weak but indicates that they are an important contributing agent that needs to be considered in etiologic PD risk assessment.

PD is not considered a hereditary condition; however, genetic risk factors should be considered as an etiology, along with environmental factors.[4] Several genes have been linked to PD, a condition in which there is an interaction of environmental factors and genetic factors, which may promote etiologic development.

The first gene linked to PD was alpha-synuclein in the 1990s. Alpha-synuclein gene mutation may be an etiologic factor in PD. Genetic mutations are known to cause disease or support the development of a disease's clinical manifestation.[5] About 15% of PD patients have a positive family history for PD, known as familial cases. Familial PD cases may be caused by mutations in the LRRK2, PARK2, PARK7, PINK1, or SNCA gene or by alterations in other genes that have not yet been identified. In addition, alterations in certain genes, including GBA and UCHL1, do not cause PD but appear to modify the risk of developing PD in some families. NPs should consider both the environmental and genetic etiologic risk factors in PD patients' history and clinical assessment.